Cognitive impairment is regarded as the link between epileptic conditions and the inability to learn in school. The neuropsychological approach to learning disabilities in epilepsy, therefore, first concentrates on analyzing the differential effects of epileptic factors on cognitive function. The impact of seizure activity, localization of epileptogenic foci, and antiepileptic treatment on cognitive functioning can be evaluated based upon the results of continuous assessment with a computerized neuropsychological test system. Second, learning disabilities may be evaluated on observations made during classroom performance. Three issues seem to predominate in learning studies among disabled children with epilepsy: test-retest variability, deterioration, and the supposed specificity of the learning disabilities.
In this study, WISC-R and WAIS suhiest profiles of mentally retarded patients with epilepsy are analysed with respect to the Verbal-Performance IQ Discrepancy scores and rank order of mean subtest scores. The relative strengihs and weaknesses in cognitive patterns of this sample are compared with subtest profiles mentioned in the literature on mentally retarded populations and samples of normal inlelligent patients with epilepsy in order lo determine the impact of epilepsy factors on cognition. The results indicate that people with mental retardation have problems with the verbal subtests Arithmetic, Voeabulaiy and Information, while patients with epilepsy have problems with (.oding (Digit Symbol), Digit Span and Information. For [his sample of mentally retarded patients with epilepsy, the most difficult subtests are Digit Span and Coding. The results concerning subtest profiles in different populations are discussed in light of the deleterious impact of epilepsy on cognition, which may superimpose the general effect of brain damage in menially retarded patients. It is suggested that especially attentional processes, as measured with the subtest Coding, are vulnerable for epilepsy factors.
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